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https://www.readbyqxmd.com/read/27920320/low-income-working-families-with-employer-sponsored-insurance-turn-to-public-insurance-for-their-children
#1
Douglas Strane, Benjamin French, Jennifer Eder, Charlene A Wong, Kathleen G Noonan, David M Rubin
Many families rely on employer-sponsored health insurance for their children. However, the rise in the cost of such insurance has outpaced growth in family income, potentially making public insurance (Medicaid or the Children's Health Insurance Plan) an attractive alternative for affordable dependent coverage. Using data for 2008-13 from the Medical Expenditure Panel Survey, we quantified the coverage rates for children from low- or moderate-income households in which a parent was offered employer-sponsored insurance...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920317/contrary-to-popular-belief-medicaid-hospital-admissions-are-often-profitable-because-of-additional-medicare-payments
#2
Jeffrey Stensland, Zachary R Gaumer, Mark E Miller
It is generally believed that most hospitals lose money on Medicaid admissions. The data suggest otherwise. Medicaid admissions are often profitable for hospitals because of payments from both the Medicaid program and the Medicare program, including payments for uncompensated care and from the Medicare disproportionate-share hospital program. On average, adding a single Medicaid patient day in fiscal year 2017 will increase most hospitals' Medicare payments by more than $300. When added to Medicaid payments, these payments often cause Medicaid patients to be profitable for hospitals...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920316/for-disproportionate-share-hospitals-taxes-and-fees-curtail-medicaid-payments
#3
Robert Nelb, James Teisl, Allen Dobson, Joan E DaVanzo, Lane Koenig
After accounting for supplemental payments, we found that in 2011, disproportionate-share hospitals, on average, received gross Medicaid payments that totaled 108 percent of their costs for treating Medicaid patients but only 89 percent of their costs for Medicaid and uninsured patients combined. However, these payments were reduced by approximately 4-11 percent after we accounted for provider taxes and local government contributions that are used to help finance Medicaid payments.
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27915137/parental-health-shocks-and-schooling-the-impact-of-mutual-health-insurance-in-rwanda
#4
Maame Esi Woode
The goal of this study was to look at the educational spill-over effects of health insurance on schooling with a focus on the Rwandan Community Based Health Insurance Programme, the Mutual Health Insurance scheme. Using a two-person general equilibrium overlapping generations model, this paper theoretically analyses the possible effect of health insurance on the relationship between parental health shocks and child schooling. Individuals choose whether or not they want to incur a medical cost by seeking care in order to reduce the effect of health shocks on their labour market availability and productivity...
November 17, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27912928/translating-self-persuasion-into-an-adolescent-hpv-vaccine-promotion-intervention-for-parents-attending-safety-net-clinics
#5
Austin S Baldwin, Deanna C Denman, Margarita Sala, Emily G Marks, L Aubree Shay, Sobha Fuller, Donna Persaud, Simon Craddock Lee, Celette Sugg Skinner, Deborah J Wiebe, Jasmin A Tiro
OBJECTIVE: Self-persuasion is an effective behavior change strategy, but has not been translated for low-income, less educated, uninsured populations attending safety-net clinics or to promote human papillomavirus (HPV) vaccination. We developed a tablet-based application (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination and evaluated its feasibility in a safety-net population. METHODS: Parents (N=45) of age-eligible adolescents used the self-persuasion application...
November 20, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27909581/expansion-of-health-insurance-in-moldova-and-associated-improvements-in-access-and-reductions-in-direct-payments
#6
Thomas Hone, Jarno Habicht, Silviu Domente, Rifat Atun
BACKGROUND: Moldova is the poorest country in Europe. Economic constraints mean that Moldova faces challenges in protecting individuals from excessive costs, improving population health and securing health system sustainability. The Moldovan government has introduced a state benefit package and expanded health insurance coverage to reduce the burden of health care costs for citizens. This study examines the effects of expanded health insurance by examining factors associated with health insurance coverage, likelihood of incurring out-of-pocket (OOP) payments for medicines or services, and the likelihood of forgoing health care when unwell...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27908531/chemotherapy-delay-after-primary-debulking-surgery-for-ovarian-cancer
#7
Brandon-Luke L Seagle, Sharlay K Butler, Anna E Strohl, Wilberto Nieves-Neira, Shohreh Shahabi
OBJECTIVE: To determine the association of chemotherapy delay with overall survival (OS) and investigate predictors of delay among a population-representative American ovarian cancer cohort. METHODS: An observational retrospective cohort analysis of women with ovarian cancer who received National Comprehensive Cancer Network guideline-consistent care was performed with the 1998-2011 National Cancer Data Base. Chemotherapy delay was defined as initiation of multiagent chemotherapy >28days from primary debulking surgery...
November 28, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27903790/association-between-health-related-beliefs-and-oral-health-behaviors-among-uninsured-primary-care-patients
#8
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Jeanie Ashby, Lea E Erickson
INTRODUCTION: The collaborations between dental care providers and other health care providers are especially needed for underserved populations. There is a deficit of research focused on underserved populations who utilize a safety net facility such as a free clinic in the United States. The purpose of this study is to examine the association between health-related beliefs and oral health behaviors among uninsured adults utilizing a primary care free clinic providing oral health care...
November 29, 2016: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/27896978/development-and-performance-of-text-mining-algorithms-to-extract-socioeconomic-status-from-de-identified-electronic-health-records
#9
Brittany M Hollister, Nicole A Restrepo, Eric Farber-Eger, Dana C Crawford, Melinda C Aldrich, Amy Non
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896666/characteristics-associated-with-hpv-diagnosis-and-perceived-risk-for-cervical-cancer-among-unmarried-sexually-active-college-women
#10
Kelly L Wilson, Clayton J Cowart, Brittany L Rosen, Jairus C Pulczinski, Kayce D Solari, Marcia G Ory, Matthew Lee Smith
Human papillomavirus (HPV) has been identified as the leading cause of cervical cancer. While HPV risk factors have been well studied, less is known about those with HPV and their perceptions about health ramifications. The purposes of this study were to examine unmarried college student women's (1) HPV diagnosis status and (2) perceived risk of getting cervical cancer in the next 5 years. Data were analyzed from 1106 unmarried, sexually active college women aged 18 to 26. Binary logistic regression compared HPV-related knowledge, vaccination-related perceptions, mandate support, healthcare utilization, sexual behaviors, and personal characteristics...
November 28, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/27896623/effect-of-the-new-maternity-insurance-scheme-on-medical-expenditures-for-caesarean-delivery-in-wuxi-china-a-retrospective-pre-post-reform-case-study
#11
Chun Chen, Zhihong Cheng, Ping Jiang, Mei Sun, Qi Zhang, Jun Lv
Aiming to control rising medical expenditures and help improve China's healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals' C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004-2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform...
November 28, 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27888090/rationale-and-design-of-mi-care-the-mile-square-colorectal-cancer-screening-awareness-and-referral-and-education-project
#12
Joanna Buscemi, Yazmin San Miguel, Lisa Tussing-Humphreys, Elizabeth A Watts, Marian L Fitzgibbon, Karriem Watson, Robert A Winn, Kameron L Matthews, Yamile Molina
Although colorectal cancer (CRC) is largely preventable through identification of pre-cancerous polyps through various screening modalities, morbidity and mortality rates remain a challenge, especially in African-American, Latino, low-income and uninsured/underinsured patients. Barriers to screening include cost, access to health care facilities, lack of recommendation to screen, and psychosocial factors such as embarrassment, fear of the test, anxiety about testing preparation and fear of a cancer diagnosis...
November 22, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27885590/payment-reform-needed-to-address-health-disparities-of-undiagnosed-diabetic-retinopathy-in-the-city-of-chicago
#13
Dustin D French, Jess J Behrens, Kathryn L Jackson, Abel N Kho, Theresa L Walunas, Charlesnika T Evans, Michael Mbagwu, Curtis E Margo, Paul J Bryar
INTRODUCTION: The Affordable Care Act (ACA) has expanded health coverage for thousands of Illinois residents. Expanded coverage, however, does not guarantee appropriate health care. Diabetes and its ocular complications serve as an example of how providers in underserved urban areas may not be able to keep up with new demand for labor- and technology-intensive health care unless changes in reimbursement policies are instituted. METHODS: A retrospective cohort study was conducted using medical encounter information from the Chicago HealthLNK Data Repository (HDR), an assembly of non-duplicated and de-identified patient medical records...
November 24, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27885306/impact-of-a-national-cancer-prevention-and-treatment-program-on-the-prevalence-of-late-stage-breast-cancer-diagnoses-in-oklahoma
#14
Amanda Janitz, Aaron M Wendelboe, Ann F Chou, Summer Frank, Angela Watkins, David Thompson, Janis Campbell
In 2000, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) to provide coverage through Medicaid to women who screened positive for breast and cervical cancer. We aimed to determine if late-stage breast cancer prevalence decreased among Oklahoma women after passage of BCCPTA. Data were obtained from the Oklahoma Central Cancer Registry during 2000-2011. We estimated prevalence proportion ratios (PPR) using modified Poisson regression between the proportion of women with late-stage breast cancer and timing of diagnosis related to BCCPTA...
July 2016: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/27875643/crowdfunding-for-medical-care-ethical-issues-in-an-emerging-health-care-funding-practice
#15
Jeremy Snyder
Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, like Canada...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27866949/perioperative-periprosthetic-fractures-associated-with-primary-total-hip-arthroplasty
#16
Kwan J Park, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Periprosthetic fracture (PPF) is a rare but devastating complication of primary total hip arthroplasty (THA). While PPF is associated with increased morbidity and mortality, early revision rate, and poor patient outcome, there is a paucity of data on patient and hospital-dependent risk factors. Using a large administrative database, we investigated epidemiology and the risk factors associated with perioperative PPF after primary THA. METHODS: We performed a retrospective review of the National Inpatient Sample records from 2006 to 2011 and identified 1062 PPFs of 1,187,969 patients using International Classification of Diseases, Ninth Revision code for PPF (996...
August 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27865018/how-would-rural-hospitals-be-affected-by-loss-of-the-affordable-care-act-s-medicare-low-volume-hospital-adjustment
#17
Rebecca Garr Whitaker, G Mark Holmes, George H Pink
PURPOSE: The low-volume hospital (LVH) payment adjustment established in the Patient Protection and Affordable Care Act (ACA) of 2010 is scheduled to sunset on October 1, 2017. The purpose of this analysis was: (1) to estimate the effect of the ACA LVH adjustment on qualifying hospitals' profitability margins; and (2) to examine hospital and market characteristics of the hospitals that would be most adversely affected by the loss of the ACA LVH adjustment. METHODS: 2004-2015 data from the Hospital Cost Report Information System, Hospital Market Service Area File and Nielsen-Claritas Pop-Facts file were used to estimate difference-in-difference regression models with hospital-level random effects in order to determine whether the ACA LVH adjustment improved qualifying rural hospitals' profitability margins...
November 16, 2016: Journal of Rural Health
https://www.readbyqxmd.com/read/27864706/influence-of-insurance-status-and-income-in-anaplastic-astrocytoma-an-analysis-of-4325-patients
#18
Jacob Y Shin, Ja Kyoung Yoon, Aidnag Z Diaz
To determine the impact of insurance status and income for anaplastic astrocytoma (AA). Data were extracted from the National Cancer Data Base. Chi square test, Kaplan-Meier method, and Cox regression models were employed in SPSS 22.0 (Armonk, NY: IBM Corp.) for data analyses. 4325 patients with AA diagnosed from 2004 to 2013 were identified. 2781 (64.3%) had private insurance, 925 (21.4%) Medicare, 396 (9.2%) Medicaid, and 223 (5.2%) were uninsured. Those uninsured were more likely to be Black or Hispanic versus White or Asian (p < 0...
November 18, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27862904/baseline-blood-pressure-control-in-hispanics-characteristics-of-hispanics-in-the-systolic-blood-pressure-intervention-trial
#19
Carlos J Rodriguez, Carolyn H Still, Katelyn R Garcia, Lynne Wagenknecht, Suzanne White, Jeffrey T Bates, Margareth V Del Cid, Michael Lioudis, Nieves Lopez Barrera, Abel Moreyra, Henry Punzi, Robert J Ringer, William C Cushman, Gabriel Contreras, Karen Servilla, Michael Rocco
The Systolic Blood Pressure Intervention Trial (SPRINT) tested whether a systolic blood pressure (SBP) value <120 mm Hg reduces adverse clinical outcomes compared with the goal of <140 mm Hg. Here the authors describe the baseline characteristics of Hispanic participants in SPRINT. Nondiabetic hypertensive patients 50 years and older with SBP 130-180 mm Hg taking zero to four blood pressure (BP) medications were enrolled from the mainland United States and Puerto Rico. Cross-sectional, bivariate analysis was employed comparing sociodemographic and clinical factors in Hispanics vs non-Hispanics...
November 14, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27859019/the-impact-of-health-insurance-on-cancer-care-in-disadvantaged-communities
#20
Zaid M Abdelsattar, Samantha Hendren, Sandra L Wong
BACKGROUND: Individuals from disadvantaged communities are among the millions of uninsured Americans gaining insurance under the Affordable Care Act. The extent to which health insurance can mitigate the effects of the social determinants of health on cancer care is unknown. METHODS: This study linked the Surveillance, Epidemiology, and End Results registries to US Census data to study patients diagnosed with the 4 leading causes of cancer deaths between 2007 and 2011...
November 14, 2016: Cancer
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